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HAND  BOOK 

OF  THE 

MENTAL  HYGIENE 

MOVEMENT  AND 

EXHIBIT 


ILLUSTRATED 


PUBLISHED  BY 

THE  NATIONAL  COMMITTEE  FOR  MENTAL  HYGIENE 

50  UNION  SQUARE 

NEW  YORK  CITY 

1913 

PRICE 
At  Exhibits         -  1 5  Cents 

Postpaid  -         -    20  Cents_ 


Publication  No.  5 


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J  i 


HAND  BOOK 

OF  THE 

MENTAL  HYGIENE 

MOVEMENT  AND 

EXHIBIT 


ILLUSTRATED 


PUBLISHED   BY 
THE  NATIONAL  COMMITTEE  FOR  MENTAL  HYGIENE 

50  UNION  SQUARE 

NEW  YORK  CITY 

1913 

PRICE 

At  Exhibits  -  1 5  Cents 

Postpaid  -  -     20  Cents 


Publication  No.  5 


Acknowledgments 

In  the  preparation  of  THE  MENTAL  HYGIENE  EXHIBIT, 
valuable  advice  and  assistance  were  given  by  a  number  of  physicians, 
psychologists  and  social  workers,  for  which  we  desire  to  make  special 
acknowledgment  to  the  following  persons: 

Dr.  C.  Macfie  Campbell,  Associate  Professor  of  Psychiatry,  Johns 
Hopkins  University; 

Dr.  Henry  A.  Cotton,  Superintendent,  New  Jersey  State  Hos- 
pital, Trenton; 

Mr.  E.  S.  Elwood,  Assistant  Secretary,  State  Charities'  Aid  Asso- 
ciation, New  York; 

Dr.  Arthur  P.  Herring,  Secretary,  Maryland  Lunacy  Commission, 
Baltimore; 

Dr.  August  Hoch,  Director,  Psychiatric  Institute,  Ward's  Island, 
New  York; 

Professor  E.  R.  Johnstone,  Superintendent,  New  Jersey  Training 
School,  Vineland; 

Dr.  James  V.  May,  Medical  member,  New  York  State  Hospital 
Commission,  Albany; 

Dr.  William  L.  Russell,  Medical  Superintendent,  Bloomingdale 
Hospital,  White  Plains,  New  York; 

Dr.  E.  E.  Southard,  Director,  Boston  Psychopathic  Hospital; 

Dr.  Charles  E.  Thompson,  Excutive  Officer,  Massachusetts  State 
Board  of  Insanity,  Boston ; 

Professor  Howard  C.  Warren,  Department  of  Psychology,  Prince- 
ton University. 

A  number  of  hospitals  for  the  insane  and  institutions  for  the  mentally 
defective  have  either  donated  or  loaned  photographs  and  other  valu- 
able material  which,  without  such  generous  co-operation,  it  would  have 
been  impossible  to  obtain.  Practically  the  entire  work  connected 
with  the  organization  and  administration  of  the  Exhibit  has  fallen  upon 
my  colleague,  Dr.  Thomas  W.  Salmon. 

STEWART  PATON,  M.  D., 

Director  of  the  Exhibit. 
3 


Contents 

I.  THE  INDIVIDUAL 

II.  THE  MENTAL  HYGIENE  MOVEMENT 

III.  THE  MENTAL  HYGIENE  EXHIBIT 

IV.  CHARTS 


I.  THE  INDIVIDUAL 


I.  The  Individual 

Is  it  possible  for  a  human  being  to  know  him  or  herself?  What 
are  the  sources  of  physical  and  mental  energy?  How  can  physical 
and  mental  activities  be  measured  and  what  are  the  means  by  which 
they  may  be  directed  so  as  to  insure  success  and  happiness  and  avert 
disaster  and  misery? 

How  does  prejudice  of  creed  or  race  develop?  Why  does  an 
idea  become  fixed,  why  do  we  strive  without  attainment,  fear  without 
cause  or  why  do  we  attempt  to  shut  out  from  our  vision  the  world 
as  we  see  it,  like  the  ostrich  which  buries  its  head  in  the  sands  of 
the  desert? 

Upon  the  answers  to  these  questions  may  be  based  hopes  for  indi- 
vidual success,  for  national  greatness,  and  for  human  progress. 

The  Object  of  the  Mental  Hygiene  Exhibit 

The  object  of  the  Mental  Hygiene  Exhibit  is  two-fold.  First,  to 
call  attention  to  some  sources  of  information  from  which  the  answers 
to  these  questions  can  be  obtained,  and,  second,  to  present  the  imme- 
diate needs  of  a  campaign  directed  to  attack  the  most  important 
and  difficult  series  of  problems  confronting  humanity.  This  plan 
can  be  effective  in  proportion  to  the  sympathy  and  support  of 
intelligent  citizens.  Success  cannot  be  attained  in  a  day  or  generation, 
but  an  organized  effort  may  now  be  made  to  co-ordinate  and  direct 
the  forces,  which,  left  unguided  by  reason,  might  overthrow  the  foun- 
dations of  our  civilization. 

Failures  in  Adjustment 

Count  the  number  of  registered  (temporary  or  permanent),  failures 
in  mental  adjustment  in  the  United  States  (Charts  XI  and  XIV). 

Remember  the  financial  cost  of  maintaining  this  host  (as  shown  in 
Charts  XII  and  XIII)  or  try  to  estimate  the  amount  of  human  misery 
and  despair  to  which  these  statistics  bear  testimony,  and  then  deter- 
mine whether  the  importance  of  these  problems  can  be  exaggerated. 

9 


What  is  the  significance  of  these  statistics,  and  what  are  some  of 
the  lessons  to  be  drawn  from  them?  It  is  of  great  importance  to  each 
one  of  us,  to  the  Nation,  and  to  Humanity  that  these  questions  be 
answered  correctly.  These  figures  give  us  some  idea  of  what  an 
appalling  number  of  people  there  are  unable  to  adjust  themselves  to 
meet  the  conditions  of  life  owing  to  a  bad  heredity,  or  to  an  unfavor- 
able environment  created  by  unnatural  social  conditions,  or  to  a  faulty 
education.  In  order  to  understand  the  relations  of  human  beings  to 
their  environment  we  must  first  have  some  idea  of  the  methods  suc- 
cessfully employed  in  the  study  of  all  living  beings. 

Life  a  Process  of  Adjustment 

Plants  like  animals  are  alive,  but  the  life  processes  in  plants  are 
relatively  simple.  Living  beings  possess  certain  activities.  Thus  the 
living  plant  or  animal  takes  in  food  and  converts  part  of  it  into  energy. 
That  is  one  form  of  activity  seen  in  the  conversion  of  potential  energy 
into  visible  movement.  A  plant  turns  its  leaves  toward  the  light  and 
in  other  ways  is  capable  of  adjusting  itself  to  its  surroundings.  Some 
of  the  lower  forms  of  animal  life  have  simple  activities  resembling 
those  of  plants,  but  neither  plants  nor  the  lowest  animal  forms  have 
that  special  mechanism  of  adjustment,  the  nervous  system,  which  char- 
acterizes the  higher  forms  of  animal  life. 

The  Mechanism  of  Adjustment 

The  mechanism  of  more  complex  adjustment  is  the  nervous  system, 
and  the  general  plan  of  its  structure,  similar  for  all  animals  which 
possess  one,  is  indicated  in  Charts  III,  IV,  V  and  VI. 

The  more  complex  the  mechanism  of  adjustment  becomes,  the  more 
varied  are  the  potential  activities  of  the  animal. 

The  area  of  the  body  in  which  the  more  complicated  adjustments 
take  place  is  the  cortex  or  outside  layer  of  the  brain.  Chart  VI.) 
This  part  of  the  adult  brain  contains  about  9,000,000,000  more 
nerve  cells  than  does  the  same  area  of  the  brain  of  an  anthropoid  ape. 
This  extraordinary  complex  arrangement  makes  it  possible  for  a  man 
successfully  to  adjust  his  activities  to  meet  countless  situations  for 
which  the  brain-mechanism  of  the  higher  apes  is  entirely  inadequate. 

10 


The  types  of  activity  of  which  different  nervous  systems  are  capable 
(Chart  II)  are: 

( 1  )  Reflex ;  the  simplest  movements  depending  on  the  presence  of 
nervous  systems, — such  as  narrowing  of  the  pupil  of  the  eye  when  it 
is  exposed  to  the  light; 

(2)  Automatic;  more  complicated  movements  unattended  by  con- 
scious activity; 

(3)  Volitional;  most  complicated  forms,  associated  with  conscious 
activity. 

These  three  types  are  intimately  dependent  on  each  other.  We 
cannot  understand  one  without  knowing  something  about  the  others. 
Volitional  activity  may,  after  a  great  deal  of  repetition,  become  auto- 
matic. The  beginner  is  painfully  aware  of  his  efforts  to  learn  to  ride 
a  bicycle,  while  later  he  may  become  unconscious  of  these  movements. 

The  Study  of  Activities 

Activities  may  be  brought  into  play  by  something  happening  at 
the  present  moment — the  hand  that  touches  a  hot  coal  is  suddenly 
withdrawn — or  by  special  mechanism  due  to  impressions  stamped  or 
engraved  on  the  body  by  previous  experience  (memory).  This  is 
the  basis  of  the  learning  process.  Certain  special  mechanisms  are 
handed  on  from  one  generation  to  another,  in  the  form  of  compound 
reflex  activities  called  instincts.  The  desire  to  live,  instinct  of  self- 
preservation,  and  of  reproduction  (sexual  instinct)  are  examples  of 
such  special  kinds  of  activity. 

When  the  higher  forms  of  activity  are  aroused  we  are  generally 
aware  of  accompanying  feelings  such  as  pleasure  or  pain.  The  char- 
acter and  intensity  of  the  feelings  vary  in  individuals,  and  in  the  same 
individual  at  different  times.  Some  people  feel  deeply,  others  are 
relatively  apathetic.  Our  moods  vary;  to-day  we  are  gay  and  to- 
morrow sad. 

In  health,  a  certain  balance  is  maintained  between  activities  and 
feelings,  which  we  call  "  normal." 

Readjustments 

Life  is  a  process  of  adjustment;  of  the  individual  to  the  environ- 
ment.    Health  is  a  state  of  mind  and  body  in  which  the  adjustments 

n 


are  relatively  good,  while  in  disease,  of  which  insanity  is  a  special  form, 
they  are  insufficient  or  imperfect. 

A  person  with  an  injured  leg  is  an  example  of  one  form  of  dis- 
turbed adjustment.  Nature  makes  an  effort  to  readjust  by  forcing  the 
uninjured  leg  to  do  extra  work,  and  its  muscles  increase  in  size. 

Again,  one  person  may  have  learned  to  play  tennis  well,  or  ride 
a  horse  easily,  almost  automatically,  while  the  automatic  activities  of 
another  attempting  to  play  or  ride  are  so  defective  that  almost  every 
movement  is  executed  clumsily  or  with  difficulty.  A  satisfactory 
adjustment  can  be  made  only  by  repeatedly  arousing  the  higher  forms 
of  activity,  acts  of  will;  that  is  by  consciously  practicing  until  the 
voluntary  movements  become  automatic. 

Readjustments  in  Higher  Levels  of  Activity 

Attempts  at  readjustment  are  constantly  being  made  within  the 
field  of  the  highest  activities.  An  individual,  conscious  of  a  mental 
or  physical  defect,  makes  an  effort  to  compensate  for  it;  he  tries  to 
make  the  best  of  a  bad  situation;  sometimes  he  attempts  to  divert 
attention  from  his  infirmity  by  boasting;  sometimes  he  tries  to  hide 
it  by  assuming  a  cynical  air. 

In  physical  and  mental  health,  the  instincts  are  held  sufficiently  in 
check  by  the  intellect  and  will,  but  when  instincts  are  unduly  re- 
pressed or  ignored  harm  may  result.  When  the  balance  among  the 
various  activities  of  the  body  is  disturbed  by  disease,  certain  of  the 
instincts  may  become  so  dominant  as  to  control  both  thought  and 
conduct;  often  mental  conflicts  arise  which  lead  to  serious  mental 
breakdown. 

Life  is  a  process  in  which  we  are  constantly  being  forced  to  meet 
new  and  changing  conditions.  In  health,  not  only  is  there,  in  general, 
a  symmetrical  balance  maintained,  but  these  activities  are  continually 
being  readjusted  to  meet  immediate  needs. 

Disorders  of  Adjustment 

The  difference  between  sanity  and  insanity  is,  in  essence,  a  differ- 
ence of  balance  among  the  activities,  a  matter  of  degree,  rather  than 
of  kind.     If  an  individual's  capacity  for  readjustment  on  meeting  new 

12 


conditions  be  not  seriously  overtaxed  an  equilibrium  may  soon  be 
restored,  when  unusual  conditions  tend  to  disturb  the  balance;  but 
should  the  altered  relationships  among  the  activities  transcend  the 
capacity  for  readjustment  then  the  disturbance  may  result  in  those 
unusual  forms  of  thought,  feeling  or  behavior  which  are  designated 
as  insanity.  A  false  idea  may  temporarily  tyrannize  our  thought 
process,  disappointment  may  bring  us  to  the  verge  of  despair;  and 
uncontrolled  passion  may  temporarily  hold  reason  in  check,  without 
raising  a  question  as  to  our  sanity.  It  is  only  when  the  idea  becomes 
fixed  or  despondency  is  our  customary  mood,  or  anger  or  fear  holds 
sway  over  all  our  emotions  that  we  are,  in  the  common  acceptance 
of  the  term  declared  to  be  insane.  There  is  no  broad  gap  between  - 
sanity  and  insanity.  People  have  naively  assumed  too  great  a  dis- 
parity between  the  mental  process  of  the  sane  and  of  the  insane. 
Their  crude  distinction  between  conditions  which  are  essentially  alike 
has  brought  untold  misery  upon  the  human  race,  has  deprived  thou- 
sands of  hope,  driven  others  to  despair,  and  prevented  us  from  knowing 
ourselves. 

The  personality  of  an  individual  depends  upon  the  adjustment, 
which  he  is  capable  of  making  and  does  make,  of  all  his  activities 
(reflex,  automatic,  volitional).  Various  inciting  agencies,  acting  at 
different  levels,  may  disturb  these  activities.      (Chart  VII.) 

There  are,  however,  a  great  many  disorders  of  adjustment  occurring 
in  the  higher  levels  of  activity  which  are  not  associated  with  recognizable 
structural  changes  in  the  nervous  system.  The  failure  to  find  changes 
in  the  nervous  system  may  be  the  result  of  our  imperfect  methods  of 
study.  Many  conflicts  among  the  activities  seem  to  occur  because 
the  individual  has  not  been  properly  trained  for  healthy  activity.  Bad 
mental  habits,  depending  often  upon  faulty  mechanisms  to  begin  with, 
or  upon  mechanisms  made  faulty  by  bad  environmental  influence,  fre- 
quently undermine  the  mental  and  physical  life  of  an  individual. 
These  faulty  mechanisms  result  in  imperfect  adjustments;  thus  arise 
seclusiveness,  brooding,  day-dreaming,  sentimentalism,  outbursts  of 
temper,  experimenting  with  the  sexual  instincts,  indulgence  in  fads,  etc. 
Disorders  of  conduct  often  make  their  appearance  when  an  individual 
has  to  face  some  difficult  situation  in  life.     In  order  fully  to  understand 

13 


the  more  complex  mental  reactions  it  is  frequently  necessary  to  have 
accurate  information  in  regard  to  the  early  development,  childhood, 
influence  of  the  family  atmosphere,  the  general  education  and  social 
environment,  the  role  of  the  sexual  instinct  and  the  habits  of  thought 
and  action,  of  work  and  of  play  of  the  individual. 

Society's  Greatest  Problems 

Can  life  be  made  easier,  happier  and  more  efficient  for  the  majority 
of  human  beings?  Is  it  possible  to  control  some  of  the  causes  which 
lead  human  beings  to  the  commitment  of  crime?  Can  we  prevent  the 
unfit  from  propagating  their  kind?  What  measures  may  be  adopted 
to  insure  the  development  of  a  race  whose  actions  shall  be  directed 
more  by  reason,  and  less  by  either  weakly  sentiment  or  boisterous 
passion?  May  we  by  taking  thought  hasten  the  time  when  the  minds 
of  men  will  be  capable  of  adjustments  which  will  permit  the  spirit  of 
humanity  and  charity  to  rule  instead  of  envy  and  malice,  vengeance 
to  give  way  to  justice,  war  to  peace,  despair  to  hope?  It  is  to  assist 
in  the  work  of  realizing  these  great  objects  by  work  in  one  important 
field  that  the  National  Committee  for  Mental  Hygiene  has  been  organ- 
ized. The  expectation  of  ultimately  attaining  these  ideals  is  a  reason- 
able one,  but  their  final  triumph  depends  upon  the  degree  of  intelligent 
interest  and  effort  that  we  put  forth  in  the  attempt  to  know  ourselves. 


14 


II.  THE  MENTAL  HYGIENE  MOVEMENT 


II.   Outline  of  the  Mental  Hygiene  Movement 

A.  PREVENTION 

1.  EUGENICS 

POSITIVE    OR    CONSTRUCTIVE 

Education  of  the  people  in  the  facts  of  heredity,  and 
cultivation  of  ideals  regarding  marriage  and  parenthood 
which  will  extend  to  the  welfare  of  the  next  generation. 
NEGATIVE  OR  RESTRICTIVE 

Legislation  denying  the  privilege  of  parenthood  to  the 
manifestly  unfit. 

2.  EDUCATION 

MEDICAL  EDUCATION 

Increased  facilities  in  medical  schools  for  giving  instruc- 
tion in  mental  hygiene  and  psychiatry. 

Especial  provision  in  medical  schools  and  hospitals  for 
training  investigators  and  teachers  in  this  department 
of  medicine. 

GENERAL  EDUCATION 

Recognition  of  the  general  principle  that  development 
of  good  mental  habits  and  not  merely  imparting  in- 
formation is  the  chief  aim  of  education. 

An  educational  system  that  takes  cognizance  of  the 
fact  that  all  our  activities  are  deeply  rooted  in  and 
inseparably  connected  with  the  practical  issues  of  life. 

More  objective  methods  of  teaching.  Especial  de- 
velopment of  the  capacity  for  observation  (drawing, 
nature  study,  etc.). 

Emphasis  upon  the  importance  of  the  manual  arts  as 
a   means   of   developing  and   maintaining   a   healthful 

interest  in  life. 

17 


The  cultivation  of  a  frank  emotional  attitude  in  gen- 
eral and  a  frank  attitude  toward  sexual  matters  in 
particular. 

Conferences  and  lectures  on  mental  hygiene  in  schools, 
colleges  and  universities  and  general  dissemination  of 
knowledge  regarding  the  basis  for  mental  activity  and 
the  causes  and  prevention  of  mental  disorders. 

Social  departments  in  schools  and  universities  where 
individuals  may  be  assisted  by  skilled  psychiatrists  in 
dealing  with  personal  problems. 

3.  SOCIAL  SERVICE 

Assistance  in  securing  adjustment  of  social  and  family 
difficulties  as  well  as  in  the  adaptation  of  employment 
to  the  capacity  of  individuals  in  danger  of  mental 
disorders. 

Perfection  of  present  methods  and  the  creation  of 
better  opportunities  than  those  existing  at  present  for 
the  study  of  individuals  in  relation  to  their  environ- 
ment. 

Advice  and  aid  in  effecting  readjustments  to  those  who 
have  already  suffered  from  mental  disorders. 

4.  GENERAL  MEASURES  OF  PREVENTION 

Movements  for  social  and  industrial  betterment,  to 
prevent  unequal  stress  and  to  give  wider  opportunities 
for  recreation  and  for  individual  improvement. 

Co-operation  between  all  existing  agencies  which  aim 
to  control  forms  of  illness  and  injury  which  may  lead 
eventually  to  mental  disorder  (venereal  prophylaxis, 
movements  against  alcoholism,  prevention  of  infections, 
regulation  of  the  sale  of  habit-forming  drugs,  safe- 
guarding workmen  in  dangerous  trades,  etc.). 
18 


Efficient  and  humane  methods  of  examining  immi- 
grants in  order  that  those  with  mental  diseases  or  de- 
fects may  be  excluded. 

B.  TREATMENT 

1 .  PROVISION  FOR  EARLIER  DIAGNOSIS  AND  TREAT- 

MENT 

Out-patient  departments  for  mental  cases  in  connec- 
tion with  hospitals  for  mental  diseases  and  general 
hospitals  and  independent  of  either  of  these  agencies. 

Systematic  psychiatric  examination  of  school  children. 

Provision  for  incipient  and  emergency  cases  in  psycho- 
pathic wards  of  general  hospitals. 

A  psychopathic  hospital  in  each  of  the  50  American 
cities  of  more  than  100,000  population;  such  hospitals 
to  be  the  centers  of  practical  work  in  prevention  and 
social  service  as  well  as  for  efficient  treatment. 

2.  IMPROVEMENTS  IN  METHODS  OF  ADMISSION  AND 

COMMITMENT 

Transfer  of  the  responsibility  for  the  care  of  patients 
pending  commitment  from  overseers  of  the  poor  and 
police  officials  to  physicians. 

Improvement  in  the  legal  steps  necessary  for  admission 
to  hospitals,  especially  elimination  of  court  measures 
which  often  imperil  patients'  chances  for  recovery. 

Extension  of  the  use  of  the  "  emergency  "  and  "  volun- 
tary "  commitments. 

3.  STATE   SYSTEMS  FOR  THE   PUBLIC   CARE   OF   THE 

INSANE  AND  MENTALLY  DEFECTIVE 

Establishment  of  complete  state  care  and  state  super- 
vision of  private  institutions,  under  strong  central  ad- 
ministration. 

19 


Elimination  of  politics  from  state  institutions;  all  ap- 
pointments and  promotions  under  strict  civil  service 
control. 

Adoption  of  a  definite  policy  for  caring  for  trie  men- 
tally defective. 

Establishment  of  after-care  and  social  service  work 
under  the  direction  or  with  the  full  co-operation  of 
state  institutions. 

4.  INSTITUTIONAL  PROVISIONS 

Sanatoriums  for  early  cases  of  mental  disorders  and 
especially  for  the  psycho-neuroses. 

Hospitals  of  moderate  size  in  cities,  with  facilities  for 
active  treatment  of  acute  cases. 

Colonies  in  the  countiy  for  more  chronic  cases  where 
patients  may  be  treated  in  small  groups,  under  at- 
tractive and  home-like  surroundings. 

5.  SPECIAL  FEATURES  OF  TREATMENT 

Increased  number  of  physicians  in  state  hospitals  and 
especial  provision  for  training  young  physicians  who 
enter  this  work. 

Encouragement  of  research  in  many  fields  (patho- 
logical, statistical,  clinical,  field  studies,  etc.). 

Better  pay,  shorter  hours  and  better  housing  for  nurses. 
Especial  provision  for  training  nurses  under  efficient 
and  well  paid  instructors. 

Especial  attention  to  such  measures  of  treatment  as 
hydrotherapy,  occupation,  recreation,  re-education, 
etc.,  under  the  supervision  of  trained  instructors. 

Provision  for  the  physical  needs  of  patients  by  provid- 
ing care  by  surgeons,  dentists,  ophthalmologists,  and 
other  specialists. 

20 


III.  THE  MENTAL  HYGIENE  EXHIBIT 


III.  The  Mental  Hygiene  Exhibit 

The  Mental  Hygiene  Exhibit  was  prepared  by  the  National  Com- 
mittee for  Mental  Hygiene  for  the  purpose  of  directing  attention  to 
some  of  the  practical  applications  of  the  study  of  human  activities  and 
of  mental  diseases  and  defects  to  problems  of  preventive  medicine, 
economics  and  education. 

THE  FIRST  SECTION  of  the  exhibit  deals  with  the  mechanism 
of  adjustment  (the  nervous  system) — its  relation  to  the  various  bodily 
activities — and  attention  is  directed  to  some  of  the  simpler  forms  of 
adjustment.  Different  types  of  nervous  systems,  from  the  simplest  to 
the  most  complex,  are  shown  and  the  levels  at  which  various  disorders 
of  adjustment  originate  or  become  manifest  are  indicated.  A  number 
of  life-histories  of  patients  with  different  types  of  those  imperfect  adjust- 
ments called  insanity,  alienation,  or  mental  disease  are  shown  and  the 
section  ends  with  charts  illustrating  the  structural  changes  in  the  brain 
found  in  some  types  of  mental  disorders.  As  indicated  in  these  charts, 
there  are  still  other  types  of  mental  disorders  in  which  no  structural 
changes  in  the  brain  can  be  observed  by  available  methods. 

THE  SECOND  SECTION  presents  statistical  information. 
Charts,  maps  and  models  indicate  the  number  of  persons  with  mental 
disorders  in  institutions  for  the  insane  and  the  number  of  the  mentally 
defective  in  the  various  states  and  also  in  foreign  countries.  These  sta- 
tistics do  not  give  an  accurate  idea  of  the  incidence  of  mental  diseases 
in  different  localities,  for  it  is  known  that,  even  in  those  communities  in 
which  the  most  intelligent  efforts  are  made  to  provide  adequately  for  the 
insane,  many  remain  uncared  for.  The  number  of  patients  in  special 
institutions  is  to  some  extent  an  index  of  the  status  of  the  care  of  the 
insane  in  a  community  and  roughly  measures  the  incidence  of  mental 
impairment  or  individual  failures  of  adjustment  in  different  localities. 
There  are,  of  course,  many  degrees  of  failure  in  adaptation  to  the  con- 
ditions of  life  which  are  the  result  of  causes  similar  to  those  leading 
to  the  graver  and  more  easily  recognized  conditions  requiring  treat- 

23 


ment  m  special  institutions  for  the  insane.  In  the  case  of  the  mentally 
defective,  no  state  provides  adequate  institutional  care  for  more  than 
one-tenth  of  these  unfortunate  persons. 

The  cost  of  caring  for  the  insane  in  institutions,  the  economic  loss 
through  mental  disease,  the  apparent  increase  in  the  incidence  of 
mental ,  disease  and  also  some  general  statistical  information,  relating 
to  age,  sex,  and  other  facts  regarding  the  insane  in  institutions  are  also 
graphically  presented. 

THE  THIRD  SECTION  deals  with  some  of  the  controllable 
causes  of  mental  disease  and  deficiency,  the  incidence  of  which  is 
shown  in  the  preceding  section.  Figures  show  that  immigration  is  a 
very  large  source  of  population  and  suggest  the  fact  that  wise  and 
humane  measures  of  excluding  the  insane  and  mentally  defective  immi- 
grants provide  us  with  a  very  practical  application  of  eugenics.  At- 
tention is  directed  to  the  role  played  by  syphilis  and  alcohol  in  the 
production  of  mental  diseases  and  the  relation  between  heredity  and 
mental  deficiency  is  also  referred  to. 

THE  FOURTH  SECTION  deals  with  the  treatment  of  those 
suffering  from  mental  disorders  or  defects.  A  copy  of  Hogarth's 
drawing  of  Bedlam,  the  first  institution  in  England  for  the  care  of  the 
insane,  marks  the  spot  where  the  long  struggle  to  ameliorate  the  con- 
dition of  those  suffering  from  mental  diseases  began.  A  copy  of 
Fleury's  painting  of  Philippe  Pinel  in  the  Salpetriere  assists  in  per- 
petuating the  name  of  this  great  man  as  one  of  the  chief  founders  of 
the  present  era  of  hospital  treatment  and  non-restraint.  Portraits  of 
Pinel,  Benjamin  Rush,  Dorothea  Lynde  Dix  and  Wilhelm  Griesinger 
and  brief  statements  of  their  share  in  this  great  work  serve  to  remind 
us  that  what  has  been  accomplished  in  behalf  of  the  insane  has  been 
due  to  the  efforts  of  men  and  women  who  devoted  themselves  to 
improving  the  conditions  of  life  for  a  group  of  unfortunate  fellow 
beings.  The  section  relating  to  the  historical  retrospect  ends  with 
pictures  of  the  early  private  and  public  hospitals  for  the  insane  in 
this  country  including  the  first  State  Hospital,  a  type  of  institution 
of  which  more  than  200  exist  in  the  United  States  to-day.  The 
"  story  of  the  insane  "  is  continued  by  charts  showing  the  conditions 
existing  under  asylum  care  which,  in  most  states,  is  now  happily  a 

24 


matter  of  history.  A  series  of  photographs  emphasizes  the  contrast 
between  asylum  care  and  modern  hospital  methods  of  treatment. 

A  number  of  charts,  which  have  been  most  carefully  collected, 
bring  out  important  phases  of  the  modern  treatment  of  the  insane  and 
mentally  defective.  Housing  of  patients  and  employees  in  public  and 
private  hospitals,  farms  and  grounds,  general  medical  features  of 
treatment,  provisions  for  special  classes  of  patients,  the  use  of  hydro- 
therapy, recreation,  diversion  and  occupation  are  some  of  the  topics 
fully  illustrated  in  this  part  of  the  section  on  "  treatment."  The  sec- 
tion ends  with  pictures  and  plans  of  the  psychiatric  clinics  and  psycho- 
pathic wards  and  pavilions  in  general  hospitals  which  break  down  the 
last  barriers  between  the  care  of  mental  diseases  and  that  of  other 
illnesses. 

THE  FIFTH  SECTION  deals  particularly  with  the  subject  of 
mental  deficiency.  The  incidence  of  mental  deficiency  (as  in- 
dicated by  the  examination  of  school  children  and  other  special  groups 
of  population)  the  causes,  evidences  and  classification  of  mental  de- 
ficiency, the  cost  to  the  community  of  failure  to  provide  for  the  mentally 
defective  and  the  question  of  the  semi-responsibility  of  the  feeble-minded 
are  some  of  the  subjects  discussed. 

THE  SIXTH  SECTION  takes  up  the  subject  of  prevention  of 
the  disorders  of  adjustment,  the  nature  and  treatment  of  which  have 
been  outlined  in  the  preceding  sections.  The  work  and  plans  of  the 
organizations  available  for  work  in  mental  hygiene  (the  National 
Committee  for  Mental  Hygiene  and  the  allied  State  Societies  and  the 
Committees  for  Mental  Hygiene)  are  indicated  in  a  series  of  charts. 


25 


IV.  CHARTS 

Selected  from  the  Mental  Hygiene  Exhibit  to  illustrate  the  preceding 
text. 


Life  is  a  Process  of  Adjustment 

JCealtk  is  a  condition  of  perfect  adjustment; 
disease  a  amdilim  f imperfect  adjustment. 


Insanity  (menial  disease')  is  a  Special  Svrtrv  of 
Disorder  of  adjustment. 

(f/Jie  fBrai/i  and  nervous  sustem  firm  tkemecfm 
ism  of  a^usirrfnt. 


Diagrammatic 


Jffihe 
Individual. 


Respiration 


Brain  and 

Nervous 

System- 


Organs  of 


^i£ahs$ 
vliocomotioii 


ImperfeAadjustaients  or  diseases  are  caused  by 

1-  Inkferetw  witktkmecAanim  of  adjustment 
(Jbrain  and  nervous  system^ 

£.  InterfkencewitJitkfunct^ 


Chart  Xo.  2 


Some  Simple  Forms  of  /Idjustment 

I.  Reflex  activity 

contraction  of  pupil  when,  exposed, 
to  tiqh£. 


2.  /Futomatic  activity 

TEore  cortiplicodecL  move- 
ments performed   wlt/i^ 
ou£  ccmscioiLS  ajciLviiu '. 


3.  Volitional  activity 

TJIotz    cairipLicaiecL   J-otttl^s 
associated    with,    cotlscuxlls 


A.  Higher  forms 
of  activity 

Dependent  upon  wilL 
concepts  and  judge 
TTieni , 


Mechanism   of  Adjustment 


Amoeta  proteus 

i         fjJreadlg  magnified} 

One  of  the  simplest  forms  of  animal  life. 

^ 'single  living  cell;  capable  of  'responding  or  'ita$u$twg  wleti  cksiurled. 
A  Sem  from  a6i?ve.  B  Seen  from  (Ae  side. 

n-  nucleus  vac*  pulsating  vacuole       f*  food  rxwiicizs 


Mechanism   of  Adjustment 


Simple  nervous  systems  (adjusting  mechanism; 

A.  Clam  B.  Snail 

&neentraii07igfwrve  cells  wio  masses 
orgaxylaz  fy roups  of  nerve  eells) 

*7ri  some  ammals  iAesefm?&z  are  scatter- 
ed ikroiy/iaul  i/ie  dodt/;  ut  oilers  i/iey  are 
located m  eerizix  defikife  areas. 


Chart  No.  5 


nofjam?iia 
-'nerve  cells  J-     ; 

'jze  shrt 

''  [v. 

0n  (  ':•/?  &f ganglia  . 


Chart  No.  6 


V) 


.6 

CO 

c 

■C 

u 

CD 


Chart  No.  7 


Levels  at which  Mental  Diseases 
(PisonJers  of  Adjustment)^  fliise 


Schema         Types  Important         Methods 

of  the  Levels  of        of  Mental  Causal      ^  °l-_ 


Instinctive 


fsychoneuroses 


Mwc-dtymsk 'disorckft. 

Variw  forms  of Ikpitssion. 
Paranoic  Conditions 


?*"•  Taultyfrainin 

ftohKOseAmek..     f0or  assimilation  of 
VenwtiaPraecox.      Instinctive  life . 


not  well '  u/utersiood;the 
following  are 
important  cduses- 

Heredity 

Certain 

traits  of 

Character. 

faultylmining, 


iotk/rniwivd/htflewtftkMrabufll/i. 

Gooptmf&a  of/^iaaas,fytM$ists{&idm 
necessary  for  this  extension, 

JpedalJtpartmerits  kScAoolfand 
uniyensitus  to  deaf  mii  ti&epatilons. 

Clinics,  dispensaries,  orStcvaus  of 
advice,  to  af/bnd  early  assistance. 


euttivaiwn  of  a.  ffranA  £motwml 
aiiituc/t  hgenerafandofakatltf 
arid  open  attitude  towards  sawl 
matters  or  particular:  0  aide 
Social  axd  6etucafien<ilfrc6teff7} 


6ihausBn?st,ekoses.     ,,  stj&utniion...       : Sssential^ Ge^rciUaqUne , 

overwork.  '  V: . 

Senile.  rsychoses.       "^^Mj^v^mi&?.'    '    .  . 

UrttrwsekrotkfJuchDses'  ''&**?!*?*%&■  ■•fa*********** 

-^  .^Stress  and  strain  of  life. 


delirium  due  to  ferer ■Fever:  General  Preventive  Illedleine, 

Rifl/»V»Pmira1     ty/v'<tyM>iif  disorders >!,  :  9Lsorairs  of^oidglrmd. 


Syphilitic.  Brain Disease.      ■  Syphilis. 
General  fFhralysis:  Tubercle. 

Tubercular' Brauidisease.     (Pellagra) 


Crusade  against  Syphilis. 
Crusade  against 9ii6eraiks'is 


Chemical 


/Zleohouc  ftyckoses..    JHeoholism.    Crusade  against JIlcvMism  and 
Drug  PsgcAoses.     2)rug  Addiction.    ®rag  dddiction. 
Jkdmigif4?M%j$axs.  TairftyJ^fodurimj  Jndustria/  hygiene. 


yrawxtdic  disorders} 


Injuries. 


Safe- guarding  workmen, 
traffie  regulation,  etc. 


Chart  Xo. 


Structural  Changes  inMenial  Diseases 

The  brainin general paresis-*  H modal  disease dependent 

upon,  &tfphel£*s. 


Tin  essentially  normal  brain 


Brain  in  general  paresis. 


Chart  No.  9 


Structural  Changes  in  Mental  Diseases 

microscopic  Plwtographs 


fortiori  of  cortex  of  an  essentially  normal  bralw 


Portion  of  cortex  in  general par&sis. 


Chart  Xo.   io 


Structural  Changes  in  Mental  Diseases 


microscopic  photograph  of  small  portion  of  brain  'at  st/pkilis. 


Brain  in,  arteriosclerosis,  showing 'destruction  of  portion 
through  obstruction  of  a  small  artery  supply ingf  it . 


Chart  Xo.   ii 


Number  of  Persons 

with  Mental  Disease 

Insane  irv  Institutions  iru  th& 
United  States 

January  1,1910  1&7^M 


jj.  Officers  and  Mis °kd  m/i,  ILSJr/ru/  32,365 

Officers  and  enlisted  men,  US.  Ikvij  50,476 
Officers  and  enlisted  men,  IIS.  Ukrlne  Corps     t) ,  o5v 

lotal  142,695 

I  Students  In  Colleges  ajwb 

Universities  in  the  United States  1  Oi  ,  7 1 Z 

C.  Vvpulaiion  of  (bhunhisr  Ohio, 
the  twenty-ninth  city  in  popu- 
lation in  ikUtutertSkks  181,543 


Chart  Xo.   12 


Cost  of  Carin6  for  the  Insane 
Cost  of  Panama  Canal. 


number  ofaisa/ie  i/t  instLi-LvtajTzs 

Uruiual  cost  oj  mainlenance 
&I7S.  OO per  capita) 

SsiuntLi£jcL  cosi  qj  comnlctuicj 
the  ^Panama  CciticlL 


IS7A54 

32,804,450 


4325,201,000 

lunc  jar  completion,  ( 1904- 1914)        ^leri  years 
JljinuaL  cosi  of construction,  *  32,520, 100 


Chart  No.  13 


Chart  No.  14 


The  Prevalence  of  Mental 

Defectiveness  in  tlxe 
United  States 

ThimMer  in,  G^r  special  institutions 

for  the  mentally  dej ceet'Ute  £->Z)*\  L/L 

Thunder  in  27 '  t^efornudorles  j~,\J*jI 

Thimber  in  17 hospitals  fir  the  insane  1  j^fol 

Total  in  108  Insiltutums  32~,830 

Jhwiber'ui  communities  Cv-ncarecL  for) 

Estimate  by 'JkH&lter^lwnaicL         166,000 

EstimaMM^  200,000 

TMbtoTopidatiaTi  1   in  500 

It  is  seen,  tkat  only  about  10  per  cent  of  all  the 
mentally  defective  in  the  United  Stales  are  under 
suitable  inslitudional  care . 

'The  fir  disk  ftoyal  Commission  has  estimated  t/wl 
but  10 per  cent  oftkc  Tnentally  defective  in  England. 

are  under  suitable  irtstituiiaruiL  care.   ... 


Chart  Xo.   i 


Mental  Examination  of  School  Children 

Results  of  examz7iuiimv)  hy  Butei-Sir/io/v  tests,  of 15 '36 
school  ehiletren  l/v  Tie pv  Jersey  £J£.J~Ct  G-oete6urct) 

"71  u  me  rats  trc  black  type  indicate,  the  mim,6er of 
^Tierrmal "  and  "backward  "chiUirerh.  fin  ttlerdat  ez^es' 
is  rmarut  the,  acje  jUierrmriej^  £>t/  the  Stszet- 
SimcrTL  testes. 

cUie  childr&n  examined  were  iatzzn,  without  selections 
from,  the  schools  of  a  city  of  5,000 population  a/at 
from  rural  districts  with  the  same  popiitiztlOTV , 


"Tri£n.iaJL    a-ges"       C  t/e.ccr'^s  J? 

•  1 

JLiuoL 
Hears 

n 

m 

IV 

V 

V] 

W 

¥111 

s 

x  |n|xn|inr 

1  \ 

4- 

0 

i 

2 

2 

3 

Brig  hi 'Children,             5 

5 

2 

4 

8 

40 

40 

\6 

4 

(  Menial  Hge  2  or  more  years 
more  than  physical,  age.) 

114 

6 

1 

0 

3 

29 

48 

69 

9      o 

i 

72or5% 

Io0 

7 

1 

£ 

8    15 

114' 50 

* 

3 

197 

8 

2 

2 

1 

87  86  16 

12. 

3 

209 

9 

0 

0 

Tl  54  56:  58 

4 

2 

201 

10 

3 

!5:24!19il24  27 

8      2 

222. 

11 

1 

4 

IS 

xo 

25  50 

GO 

12 

I 

166 

12 

4 

\S 

42 

36 

S3    0 

144 

\3 

14 

15 

^pefe 

TtUnta 
years 

aal) 

ciive"  ChiLcLreru 

J-  aye  3  err  -mcrre, 
less  -than  iciactls 

50 or  3.5% 

1 

5 

6 

30 

19 

121  ■  7 

89 

1 

1 

6 

5 

4  |3 

20 
6 

3 

0 

1 

Z   0 

"Totals 

3 

6 

T7 

81 

in 

337 

256 

143 

326 

\55 

88 

13 

1536 

Chart  JNo.  id 


Alcohol  and  Mental  Diseases 

JllcoholLc  psucfuoses  [-me.Tz£aL  diseases  hjbcwJTV   £o  be^ 
caused  by  alcokoL )  ul-  cLiff<zre.Tub    <znvLro7i77i£,wLs+ 

t^irsi  admissions  £o  hospitals  for  ike  uzsarte, 
(Skaded  areas  indicate,  perceniaaes  of  alcoholic  psucfvoses^) 

Men 
City  Country 


Women 
City  Country 


Chart  No.  17 


Syphilis  and  Mental  Diseases 

^Tke  Incidence  of  General  Paresis  (a  type  ofmetdal 
disease  depending  upon  previous  infection  wdk  suphilisi) 


134 
Deaths  from  small  pox 
Sniire  United State  -ffll 


S90 
Peaths  from,  general  paresis 
flew  Stork  Stoic- 191  1 


Chart  Xo.   18 


Syphilis  and  Mental  Diseases 

Wfiere  general  paresis  is  mos£  pre  vaXarut  ^ 

'y^irst  admissions  io  kospdals  for*  tk&    insane, 
fSkadcd  areas  indicaie  percentage  of  general  paresis) 

Men 
(Zity  Cotxntry 


Women 
City  Country 


Chart  No.  19 


Immigration  and  Eugenics. 

life  am  exclude  insane  and  menially  defective 
immigrants  bid  d  Is  mack  more,  difficuft 
to  apply  the  principles  of  eugenics. 

Immigration  and  Births  as  Sources  of  Population 


\ 

[^^W^^g 

Immigrants  destined  to  Hew  fork  State  who  arr'wed  in  1912 
239,  2.7 & 


births  in,  ffletv  &ork,  Stale  irh  131  Z. 
216,  141 


Chart  Xo.  20 


Chart  Xo.  21 


Causes  of  Mental  Deficiency 


Heredity 


Congenital 
defects 


nj  ll  ri  es  Paring 
BirtK 


Diseases  daring 
Infancy 


Injuries  during  Infancy 
fhyroid  Insufficiency 


rtjlental  defectiveness 
Irtsa-nttif 
■I  Epilepsy 
TUcofuolLsrrZs 
^Syphilis 

Hydro cep  ^^xLzs 
TTLLcrocep /tolas 
Defects  in,  cerebral  siLDstcui&z, 
Defects  resulting  in.  menial 
cteprutatLori* : 

Blind/Less 
7TLlv£lsttZs 

£>&afrvess 

Fraciare,  <yf  sh.u,lL 
Compress  iorv  of  hrral.ru 
CerebraL  hemjor rfacuye, 
fUsphifjcicL 

fbcute  inyectLcnis  diseases  t 

Scarlei  fe-ver, 

Prveu  mania,  etc. 
Viscoses  direc  tlu  affec  ting  -the  oral  w  \ 

Infantile  ccephalitls 

TfLenutgLtis 

Syphilis 

Infantile  convuls'ums,  etc 
Epilepsy 
JTlatrLut  rilicm^ 


Chart  Xo.  22 


Heredity  and  Mental  Defect 

J  he  descendants  of '  Uokrv  ZfoUlLhaJz,  "  a.  <^e.voLa£LOTixz.r' Lf 
soldier  (A)  his  lawful  wife  and  (B)  iJue  feeble  -minded  alauahler 
of   ojv    l7z.tt^~   h.e,<z.p<z.r* . 
(  from.  ~ciHe  Xizllika&s;  by  K.7C.  GoddarcL  ) 


436  direct  de-scenelcuvts  • 
none  menially  cLef&ctive, 


B 


480  direct  desce-izdcLnds  ■ 
1*4-3  feeble  -  jTvlnjcLect, 
44    normal 
293    u.n.de±emvLrve.cL  crr 
O-Tva^scer  tainted. 


The  normal  woman  Volui  fadlikak" 

wAom  k&  married,  barn,  1755 


The  feeble -minded 
girl  by  wharn  he  had  an, 
idLUj-JLrruvte  ^otq  , 


Debora.  /cxzllckak. 
born,  1889 


□  1lormaL 
TTLale 


o 


Tlormal 
'Female 


"Feeble-minded 
TTlale. 


re&ble  -minded, 
^enuile,- 


Chart  No.  23 


ft 


H 


c 


Chart  No.  24 


Friends  of  the  Insane 
Benjamin  Rush 


174S-1.S13 


Chart  No.  25 


Friends  of  the  Insane 
Dorothea  Lynde  Dix 


1802-1887 


Chart  No.  26 


Friends  of  the  Insane 
WilhelinGriesinger 


181T-138S 


Chart  No.  27 


Chart  Xo.  28 


Asylum  Care  vs.  Hospital  Treatment 

HoLLsi  n^f> 


*  Insane  department"  of  a  county  almskoiise 


Day  room  in,  a  modern  State  J&spttal. 


Chart  No.  29 


Asylum  Care  vs.  Hospital  Treatment 

Treatment  of  excited  patients 


Tlurses  Ulastn 

(abandoned  lit 


use  ofrestmbit  apparatus 


Patient  \  iu  continuous  batk  of  tepid  water 

(often,  used  corttiruzoizshf  jor  c&zz/&  or  LUeekjS^) 


Chart  No.  30 


Asylum  Cue  vs  Hospital  Treatment 

How  the  lon<5  days  are  spent 


1 

H  ■■ '        MB? 


'X 


Idleness  and  solitude  [a  County  Hsylum) 


Occupation  andannpanlmship  (a  State  Hospital) 


Chart  Xo.  31 


The  National  Committee  for  Mental  Hygiene 

50  UNION  SQUARE,  NEW  YORK  CITY 


President 
DR.  LEWELLYS  F.  BARKER 


Vice-Presidents 
DR.  WILLIAM  H.  WELCH 
CHARLES  W.  ELIOT 


Treasurer 
OTTO  T.  BANNARD 


Director  of  Special  Studies 
DR.  THOMAS  W.  SALMON 


Secretary 
CLIFFORD  W.  BEERS 


DR.  GEORGE  BLUMER,  Chairman,  Executive  Committee 
PROF.  RUSSELL  H.  CHITTENDEN,  Chairman,  Finance  Committee 
DR.  WILLIAM  L.  RUSSELL,  Chairman,  Committee  on  Survey 
DR.  STEWART  PATON,  Director  of  Mental  Hygiene  Exhibit 

MEMBERS 


Mrs.  Milo  M.  Acker,  Hornell,  N.  Y. 

Jane  Addams,  Chicago 

Edwin  A.  Alderman,  Charlottesville,  Va. 

James  B.  Angell,  Ann  Arbor,  Mich. 

Dr.  Pearce  Bailey,  New  York 

Dr.  Charles  P.  Bancroft,  Concord,  N.  H. 

Otto  T.  Bannard,  New  York 

Dr.  Lewellys  F.  Barker,  Baltimore 

Dr.  Albert  M.  Barrett,  Ann  Arbor,  Mich. 

Dr.  Frank  Billings,  Chicago 

Surg. -Gen.  Rupert  Blue,  Washington 

Dr.  George  Blumer,  New  Haven 

Dr.  G.  Alder  Blumer,  Providence 

Russell  H.  Chittenden,  New  Haven 

Dr.  L.  Pierce  Clark,  New  York 

Dr.  William  B.  Coley,  New  York 

Dr.  0\Ven  Copp,  Philadelphia 

Dr.  Charles  L.  Dana,  New  York 

Charles  W.  Eliot,  Cambridge 

Dr.  Charles  P.  Emerson,  Indianapolis 

W.  H.  P.  Faunce,  Providence 

Dr.  Henry  B.  Favill,  Chicago 

Di.  Walter  E.  Fernald,  Waveriey,  Msss. 

Catherine  S.  Felton,  San  Francisco 

Irving  Fisher,  New  Haven 

Matthew  C.  Fleming,  New  York 

Horace  Fletcher,  New  York 

Homer  Folks,  New  York 

James,  Cardinal  Gibbons.  Baltimore 

Arthur  T.  Hadley,  New  Haven 

Henry  L.  Higginson.  Boston 

Dr.  August  Hoch,  New  York 

Mrs.  William  James,  Cambridge 


David  Starr  Jordan,  Palo  Alto,  Cal. 

Harry  Pratt  Judson,  Chicago 

John  Koren,  Boston 

Julia  C.  Lathrop,  Washington 

Samuel  McCune  Lindsay,  New  York 

George  P.  McLean,  Simsbury,  Conn. 

Dr.  William  Mabon,  New  York 

Marcus  M.  Marks,  New  York 

Lee  Meriwether,  St.  Louis 

Mrs.  Philip  N.  Moore,  St.  Louis 

Dr.  J.  Montgomery  Mosher,  Albany 

Cyrus  Northrop,  Minneapolis 

Dr.  Stewart  Paton,  Princeton 

Francis  G.  Peabody,  Cambridge 

Dr.  Frederick  Peterson,  New  York 

Henry  Phipps,  New  York 

Gifford  Pinchot,  Washington 

Florence  M.  Rhett,  New  York 

Jacob  A.  Rus,  New  York 

Dr.  William  L.  Russell,  White  Plains,  N.Y 

Jacob  Gould  Schurman,  Ithaca 

Dr.  Elmer  E.  Southard,  Boston 

Dr.  M.  Allen  Starr,  New  York 

Anson  Phelps  Stokes,  Jr.,  New  Haven 

Melville  E.  Stone,  New  York 

Sherman  D.  Thacher,  Nordhoff,  Cal. 

Victor  Morris  Tyler,  New  Haven 

Henry  van  Dyke,  D.D.,  Princeton 

Dr.  Henry  P.  Walcott,  Cambridge 

Dr.  William  H.  Welch,  Baltimore 

Benjamin  Ide  Wheeler,  Berkeley.  Cal. 

Dr.  Henry  Smith  Williams,  New  York 

Robert  A.  AYoods,  Boston 


The  Chief  Objects  of  the  National  Committee  for  Mental  Hygiene  are: 

To  work  for  the  protection  of  the  mental  health  of  the  public:  to  help  raise  the 
standard  of  care  for  those  threatened  with  mental  disorder  or  actually  ill;  to  promote  the 
study  of  m;ntal  disorders  in  all  their  forms  and  relations  and  to  disseminate  knowledge 
concerning  their  causes,  treatment  and  prevention;  to  obtain  from  every  source  reliable 
data  regarding  conditions  and  methods  of  dealing  with  mental  disorders;  to  enlist  the  aid 
of  the  Federal  Government  so  far  as  may  seem  desirable;  to  co-ordinate  existing  agencies 
and  help  organize  in  each  State  in  the  Union  an  allied  but  independent  Society  for 
M;ntal  Hygiene,  similar  to  the  existing  Connecticut  Society  for  Mental  Hygiene. 

Inquiries  re^ardin^  the  work  and  requests  for  pamphlets 
issued  by  the  organization  should  be  addressed  to  Clifford 
W.  Beers,  Secretary,  The  National  Committee  for  Mental 
Hygiene,  Room  1914,  No.  50  Union  Square,  New  York  City, 
or  to  Dr.  Thomas  W.  Salmon,  Director   of  Special  Studies. 


COLUMBIA  UNIVERSITY 

This  book  is  due  on  the  date  indicated  below,  or  at  the 
expiration  of  a  definite  period  after  the  date  of  borrowing, 
as  provided  by  the  rules  of  the  Library  or  by  special  ar- 
rangement with  the  Librarian  in  charge. 


C28'638)M50 


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ALBANY,  N.  Y. 


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